Older adults are frequently excluded from preventive health interventions and underrepresented in cancer screening studies, especially in low and middle income countries (LMICs). Colorectal cancer (CRC), strongly linked with ageing, is Nepal’s fourth most common cancer, yet systematic screening is lacking. This study explored representativeness in CRC screening by actively including older adults. A prospective mixed-methods pilot was conducted at GWTN (August-December 2024). Adults aged 45–85 years were offered fecal immunochemical testing (FIT). FIT-positive participants were referred for colonoscopy. Structured questionnaires assessed patient awareness, experience, and willingness for future screening, a parallel survey captured staff perspectives. Of 1,166 adults counseled, 1,029 (88.2%) participated, with 105 (10.2%) testing FIT-positive. Colonoscopy uptake was high (85.7%), revealing clinically significant lesions, including advanced adenomas. Older adults up to 85 years showed strong participation, challenging conventional upper age limits. In-depth interviews (n=70) reported “very good” experiences. Staff feedback (n=15) emphasized teamwork and positive outcomes. This pilot highlights the importance of inclusivity in preventive health research. Demonstrating both the feasibility and acceptability of CRC screening among the oldest-old, it underscores the need to avoid age exclusions. Representativeness requires that ageing populations are not left behind. Findings from Nepal provide relevant lessons for broader Asian contexts.

Authors:
Anu Dahal, Gurkha Welfare Trust Nepal, Nepal
Gerda Pohl, Gurkha Welfare Trust Nepal, Nepal

About the Presenter(s)
Dr. Anu Dahal is an Internal Medicine and Occupational Physician at the Gurkha Welfare Trust Nepal. She led Nepal’s first FIT-based colorectal cancer screening pilot, including adults up to 85 years, now expanded to 20,000+ participants.

Connect on Linkedin
https://www.linkedin.com/in/dr-anu-dahal-1b054a321/

See this presentation on the full schedule – Wednesday Schedule

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